Abstract
INTRODUCTION: Since the start of the neurosurgery training program in Ethiopia, the specialty has significantly grown both in terms of service provision and quality of surgeries. Locally trained neurosurgeons are now able to operate on complex skull base tumors. Our study used a retrospective design of an in-hospital series of skull base meningiomas with short-term follow-up. METHODS: A total of 100 patients (mean age, 40.2 years;80% women) had undergone surgery for skull base meningiomas from 2016 to 2017. Their symptoms included headache in 90%, impairment of vision in 47%, gait impairment in 25%, cognitive dysfunction in 29%, and seizures in 18%. Of the 100 tumors, 44% had a diameter >50 mm. Microsurgery was performed using the Hudson drill, Gigli saw, and conventional microsurgical instruments. RESULTS: A total of 59 complications in 39 patients occurred. Eleven patients had died within 3 months postoperatively. The cranial infection rate was 14%. The rate of Simpson grade I and II was 63%. We present the 3 -12 month outcomes for 84 of the 100 patients. Of the 16 remaining patients, 4 were lost to follow-up (mean, 6.7 months) and 12 had died. Headache was noted in 65 of 74 patients preoperatively and in 20 during follow-up. Overall,33 patients reported better vision, 48 reported similar vision, and 3 patients reported worse vision. Finally, 20 patients had gait difficulties preoperatively and 9 reported impaired gait during follow-up. CONCLUSION: A young faculty of locally trained neurosurgeons in a low income country, Ethiopia, were able to do large skull base meningiomas. The patients had presented at a young age with severe disabilities due to advanced disease. Surgery led to symptom improvement in a large proportion of patients. The outcome of patients was promising; however, there should still be improvement on the resource limitations faced.